title: Incorporation of a virtual assessment into a care pathway for initial glaucoma management: feasibility study.
abstract: OBJECTIVE
  To investigate the feasibility of a glaucoma triage assessment based on the consideration of clinical data in a virtual clinic environment.
  
  
  METHODS
  One hundred consecutive new patients were assessed by masked observers for a possible diagnosis of glaucoma or ocular hypertension by evaluation of clinical data compiled by a technician in the absence of the patient. The virtual clinic diagnoses were compared with those made by actual examination of the patient in the outpatient clinic.
  
  
  RESULTS
  A total of 22% of subjects were excluded from interobserver comparison because of atypical scanning laser ophthalmoscopy. Of the 78% of subjects completing virtual and actual clinical assessments diagnostic agreement was good, weighted Kappa was of 0.72 (95% confidence interval 0.85 to 0.59), sensitivity 94.4% and specificity 86.7%. No case of glaucoma was misdiagnosed as normal by virtual assessment.
  
  
  CONCLUSIONS
  Clinical findings and data relating to glaucoma may be evaluated in a virtual clinic with satisfactory diagnostic accuracy.
authors.affiliation: Department of Ophthalmology, Singleton Hospital, Swansea, UK.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Rathod
authors.forename: Thein
authors.initials: T
authors.lastname: Win
authors.forename: Susan
authors.initials: S
authors.lastname: Pickering
authors.forename: Michael
authors.initials: M
authors.lastname: Austin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003941:Diagnostic Techniques, Ophthalmological / Q000592:standards*; D005240:Feasibility Studies; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012015:Reference Standards; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014218:Triage